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For more information about
these and other continuing
dental education courses
contact:
University o Michigan
School o Dentistry
Ofce o Continuing
Dental Education
1011 N. University Avenue
Room G508
Ann Arbor, MI 48109-1078
www.dent.umich.edu.
Mark Your Calendar:
Upcoming Continuing Dental Education Courses
December 7, 2007 (Friday)
Evidence-Based Dentistry and Dental Practice
This course will defne and critique the concept o evidence-based dentistry.
A protocol or practicing evidence-based dentistry (EBD) will be described and
how it can be used to provide inormation to patients. The course will ocus on
the process o conducting evidence-based practice, how to prevent the abuse o
EBD in a clinical practice, sources o critical inormation, the new ADA National
Library o Medicine project, and how practitioners can interact to provide
eedback and ask questions on best evidence or clinical care.
Location: U-M School o Dentistry, Ann Arbor
January 25, 2008 (Friday)Innovative Strategies for the Prevention, Early Detection, and
Treatment of Oral Cancer
In this course, Dean Peter Polverini will present the most current inormation
about the causes o oral cancer, describe new chairside methods to rapidly
detect premalignant oral lesions, and discuss some exciting new strategies
designed to prevent recurrent oral cancer. The development o some new
therapies or this disease will also be discussed.
Location: U-M School o Dentistry, Ann Arbor
March 28, 2008 (Friday)Dialogues in Orthodontics: Mini-Pins and Mini-Plates as Skeletal
Anchorage
Dr. Axel Bumann and Dr. Hugo De Clerck, who were well received at the
School o Dentistrys Moyers Symposium earlier this year and spoke about
microimplants as temporary anchorage in orthodontics, are returning to Ann
Arbor to present their material in greater detail.
Dr. Bumann will ocus on the undamentals o mini-pin anchorage in the
correction o a variety o malocclusion types, discussing site selection and
the use o sel-tapping vs. sel-drilling screws. Dr. De Clerck will ocus on the
use o modifed mini-plates or skeletal anchorage, including the details o
orthodontic and surgical management.
Location: The Michigan League, U-M Central Campus, Ann Arbor
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In recent years, more than 11,000 patients have annually been
to our Patient Admitting and Emergency Services (PAES) Clinic as
their irst step toward better oral health.
About 5,000 have received emergency care. In act, we oten
reer to the PAES Clinic as the dental schools version o a hospital
emergency room.
For another 6,000 patients, the PAES Clinic is their irst stop
to receiving longer-term comprehensive care and treatment in our
Schools clinics.As you will learn reading this issue oDentalUM, the Clinic
serves many patients who live within a 30- or 40-mile radius o
Ann Arbor.
However, others drive two, three, our, and sometimes ive
hours rom western Michigan, northern lower Michigan, and
even the Upper Peninsula to receive care here.
Dr. Stephen Steanac, our associate dean or patient services
who oversees the Clinics activities, says that with the state o
Michigans economy being what it is, we are now seeing more
patients than ever who have no where else to be treated or
their conditions. In many instances, were the providers o last
resort.The PAES Clinic, however, is not just a treatment acility. Since
it is an essential part o our School, it provides our dental students
with learning opportunities and gives them chances to educate
patients about proper oral health care.
The Clinics three sta dentists Drs. David Jacobson, Juan
Johnson, and Vernon Rie work with the dental students to help
them develop their skills, increase their comort level in dealing
with emergency situations and, ultimately, develop their own
style.
I think Dr. Jacobson summarizes what the Clinic means to all
o us when he says, For me, its incredibly gratiying when you
can both help a patient and teach a student something new about
the art and science o dentistry.
Sincerely,
Peter J. Polverini, Dean
DentalUM magazine is published twice a year by theUniversity o Michigan School o Dentistry, Oice o
Alumni Relations and Continuing Dental Education.
Mail letters and updates to: Jerry Mastey, Editor, School
o Dentistry, Room G532, 1011 N. University Ave., AnnArbor, MI 48109-1078. Or you may send your letters andupdates via email to: [email protected].
Dean . . . . . . . . . . . . . . . . . . . . . . . . Peter PolveriniDirector o External Relations and
Continuing Dental Education . . . . . . Richard FetchietWriter & Edit or . . . . . . . . . . . . . . . . . . Jerry MasteyDesign . . . . . . . . . . . . . . . . . . . . . . . . . Chris Jun gContributing Photographers . . . . . . . . . Per Kjeldsen,
Russell Taichman, Jerry Mastey, Wanda Snyder,Diane McFarland
Member publication o the American
Association o Dental Editors
The Regents o the University:
Julia Donovan Darlow, Laurence B. Deitch, Olivia P.Maynard, Rebecca McGowan, Andrea Fischer Newman,
Andrew C. Richner, S. Martin Taylor, Katherine E. White,Mary Sue Coleman, ex officio.
University o Michigan School o Dentistry
Alumni Society Board o Governors
Terms Expire 2007:
Samuel Bander, 81, Grand Rapids, MI
Richard L. Pascoe, 70, Traverse City, MISusan Pritzel, 67 DH, Ann Arbor, MI (chair)
Terry Timm, 71, Saline, MI
Josephine Weeden, 96, 99, Saline, MI
Terms Expire 2008:
William E. Brownscombe, 74, St. Clair Shores, MIJohn R. McMahon, 82, Grand Rapids, MI
George M. Yellich, 72, Los Gatos, CAHarold Zald, 79, West Bloomield, MIJemma Allor, 00, Dental Hygiene, Mt. Clemens, MI
Terms Expire 2009:
Charles Caldwell, 77, Grand Rapids, MIDaniel Edwards, 97, Ann Arbor, MI
Gary Hubbard, 78, Okemos, MIMetodi Pogonche, 76, Lansing, MIJanet Souder Wilson, 73, Dental Hygiene, Northville, MI
Student Representative: Jamie Luria (D4)
Ex Officio Members:
Peter Polverini, DeanJanet Souder Wilson, 73, DH, Northville, MI
Alumni Association LiaisonSteve C. Graton , Executive Director, Alumni Assoc.Richard R. Fetchiet, Director o External Relations and
Continuing Dental Education
The Universit y o Michigan , as an equal opportun ity/a irmati ve actionemployer, complies with all applicable ederal and state laws regardingnondiscrimination and airmative action, including Title IX o theEducation Amendments o 1972 and Section 504 o the RehabilitationAct o 1973. The University o Michigan is committed to a policy onondiscrimination and equal opportunity or all persons regardlesso race, sex, color, religion, creed, national origin or ancestry, age,marital status, sexual orientation, gender identity, gender expression,disability, or Vietnam-era veteran status in employment, educationalprograms and activities, and admissions. Inquiries or complaintsmay be addressed to the Senior Director or Institutional Equity and
Title IX/Sec tion 504 Coordina tor, O ice o Instit utional Equity, 2072Administrative Services Building, Ann Arbor, Michigan 48109-1432,734-763-0235, TTY 734-647-1388. For other University o Michiganinormation call 734-764-1817.
* Includes discrimination based on gender identity and gender expression.
DentalUM
Our Schools Gateway
to Better Oral Health
Fall 2007 Volume 23, Number 2
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COVER STORY
FEATURES
16 The PAES Clinicthe Gateway to Better Oral Health
The School o Dentistrys Patient Admitting and Emergency Services (PAES)Clinic is the gateway to better oral health that serves the public in two vitalways. One is providing emergency care. The other is screening patientswho will receive long-term comprehensive care. More than 11,000 patientshave been treated annually at the Clinic in recent years. Many live withina 30- or 40-mile radius o Ann Arbor. However, others drive two, three, andsometimes our hours to receive care.
Pictured are: Dr. Stephen Steanac (seated), associate dean or PatientServices, who oversees the Clinics activities; Dr. Vernon Rie (let), sta dentist;Dr. David Jacobson (center), Clinic director; and Dr. Juan Johnson, sta dentist.
22 Fourth-Year Dental Students Say Clinic A Very Valuable Experience26 On the Front Line Drs. David Jacobson, Juan Johnson, Vernon Rie29 Adjunct Faculty Teach Students, Help Patients
Design by Chris Jung. Photo by Per Kjeldsen.
4 Deans Speak o Importance o Transorming Health Care Education
Dean Peter Polverini spoke o the School o Dentistrys commitment to
developing alternatives to educating oral health proessionals o theuture at the annual convocation ceremony. Guest speaker Dr. James
Woolliscrot, dean o the U-M Medical School, spoke o the need or an
integrated approach to proessional health care education.
7 Paperless Records a Reality in Browne Orthodontics Clinic In late July, the Robert W. Browne Orthodontics Clinic completed a
transition rom an environment where patient inormation had been
stored on paper to one that is now completely electronic.
8 New Pain Clinic Extends Dental-Medical Collaboration
9 Dental Scholars Help Area School
U-M School o Dentistry Dental Scholars made a major dierence at anAnn Arbor School this summer. Their community service helped the
Perry Nursery School save about $1,800.
13 U-M Dentist Invents Product or Clinics
Dr. Louie Khouri (DDS 1989) has invented a product he believes can helporal health care proessionals and their patients.
30 Faculty Prole Dr. Stephen Steanac, Associate Dean or Patient
Services
He supervises one o the Schools largest departments with more than
80 employees. But when he told his high school guidance counselor
about his plans to become a dentist, the counselor told Stephen
Steanac that he should frst take a pottery or ceramics class.
7
30
13
In This Issue ...
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EPARTMENTS
Fall 2007
38 Alumna Prole Dr. Patricia LucasMy parents were strict, wanted us to go to college, earn a degree,
and become proessionals, says Dr. Patricia Lucas. They frmlybelieved and told us oten that hard work and a good educationwere the keys to success.
41 Graduation 2007School o Dentistry graduates were reminded o the Schoolstradition o excellence and innovation and also urged to advancethat tradition to beneft society.
36 Faculty News
46 Development51 Dental Hygiene
51 - Online Degree Program Begins in January
A new programthis one onlineleading to a Bachelor o Science
degree in dental hygiene will be oered by the School o Dentistry
beginning in January.
52 - Alumna Urges Congress to Expand Healthy Kids Dental
Program
Dental hygiene alumna Christine Farrell recently appeared beore
a Congressional committee urging lawmakers to help the State o
Michigan expand the Healthy Kids Dental Program.
57 Research News 57 Saliva Test Kit Advances in Testing
New test results show a portable device developed by a School o
Dentistry proessor could tell patients in just minutes i they have
periodontal disease, which would be a major improvement over
current methods.
58 New Programs Put Money in Students Pockets
Two new programs designed to attract more dental students tocareers in clinical research oers them opportunities to learn and
earn. A one-year program oers a year o ully-paid tuition and
a stipend o about $20,000. A three-month program includes a
stipend o nearly $5,200.
66 Research Fulflling, I Want to Stay InvolvedIt seemed the Michigan Center or Oral Health Research was myhome away rom home, said dental hygienist Janet Kinney as she
talked about her 18 months o clinical research.
72 Department Update: Orthodontics and Pediatric Dentistry
80 Alumni News
81 In Memoriam Dr. Thomas Graber, Keary Campbell
58
51
66
41
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o m e o t h e S c h o o l o
Dentistrys most important
achievements during the
past year, and a hint o
things to come, were presented by Dean
Peter Polverini during the Schools
ourth convocation ceremony in
August.
During the annual ceremony,which celebrates the start o the new
academic year, he highlighted some o
the achievements o the past 12 months
and identiied uture challenges and
opportunities or the School.
Perhaps the single most important
accomplishment this past year was
the completion o our strategic sel-
assessment, Polverini told students,
aculty, and sta.
Beginning in March 2005, a
21-member committee o aculty,
students, and sta perormed a critical
introspective analysis o the Schools
strengths and weaknesses. [DentalUM,
Spring & Summer 2006, pages 8 to
13.]
As part o the process , we
deined a vision or the uture that
included developing a new clinical
education model, a major investment
in technology to support our education
and patient care programs, targeted
growth o our research enterprise,
and a commitment to revitalize our
research and patient care acilities,
he said.
In late August, a team o external
reviewers visited the School to review
Completing Strategic Self-Assessment
and discuss the sel-assessment.
The indings rom the visit will be
submitted in the all to U-M President
Mary Sue Coleman and Provost Teresa
Sullivan.
Educational Programs
A m o n g t h e m a n y r e c o m -
mendations developed during ourstrategic assessment was the key
conclusion that we must explore
alternatives to our current predoctoral
clinical education program, Polverini
said. We must transor m the
predoctoral, hygiene, and graduate
educational programs so they serve
as role models or dental education
in terms o innovation and inancial
sustainability.
He added that the programs
must continue to emphasize the
Schools commitment to educating
the oral health proessional o the
uture, encouraging exploration and
discovery, and creating excitement
about academic dentistry as a career
choice.
To help ease an impending national
shortage o dentists-scientists, while
seeking to improve the publics oral
health, we will expand our emphasis
on educating dental special ists ,
masters, and doctoral level dental
scholars, he said.
We will consider more sel-
directed orms o education that will
enable students to take more control
o their learning. We will challenge
them to explore and participate in
developing new, innovative educational
collaboration, he added.
Research and Discovery
Polver in i sa id research and
discovery cont inues to be the
centerpiece o the School o Dentistry.
The work we do in our researchlaboratories and clinics distinguishes
us rom our peers and enables us to
attract some o the best aculty and
students rom around the world.
He noted that during 2006, the
School ranked irst in research and
training award grants rom the
National Institute o Dental and
Cranioacial Research, a part o the
National Institutes o Health, totaling
more than $10.6 million.
During the same time, the School
was second among the nations
dental schools receiving more than
$13 million in research and training
awards rom NIH.
In addition to laboratory research,
Polverini highlighted the leading role
the School is playing in addressing
the problem o access to care. Under
the leadership o Dr. Amid Ismail, the
Detroit Center or Research on Oral
Health Disparities is investigating the
social, economic, environmental, and
biological causes o disparities in oral
health.
External Impact
Polverini said the School o Dentistry
Dean Outlines New Initiatives During Annual Ceremony
S
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DENTISTRY
will continue to establish unique
interdisciplinary collaborations with
other U-M schools and colleges andother institutions o higher learning
around the world.
The creation o new knowledge
and the advancement o best practices
will be the guiding principles in
establishing new educational and
research partnerships locally and
globally.
The learning curve will be steep
as we come to grips with the cultural,
economic, and political realities both
here and abroad, he said. We have
little choice but to move this agenda
orward i we hope to expand our
global presence.
Global Collaboration
Polverini said that during the
past year, the School established
memoranda o understanding with
dental schools in England, Brazil, andChina. [See sidebar.]
In the months ahead, he continued,
U-M and the School o Dentistry will
explore emerging global opportunities.
Working with other U-M units, the
School o Dentistry wil l develop
cultural immersion programs that
that will support aculty and students
in this eort.
As we begin the new academic
year, we will continue to ace signiicant
challenges that, i not addressed, will
impede our vision to become a school
o the uture, he said. I am conident,
however, that we have the people in
place who have the ingenuity and
creativity to shepherd our School
through these trying times.
Memoranda ofUnderstanding
The School o Dentistry establishedmemoranda o understanding withthese dental schools around the worldduring the past year:
UniversityofLeeds(England)
UniversityofSaoPaulo(Brazil)
FederalUniversidadeRioGrande
doSul(Brazi l)
ShanghaiJiaotongUniversity
(China)
PekingUniversity(China)
FourthMili tary Medical
University-Xian(China)
XianJiaotongUniversity(China)
our Most Important AccomplishmentJerry Mastey
DeanPeterPolverinispokeoftheSchoolofDentistryscommitmenttodevelopingalternativestoeducatingoralhealthprofessionalsattheSchoolsannualconvocationceremony.
Guestspeaker,Dr.JamesWoolliscroft,deanoftheU-MMedicalSchool,spokeoftheneedforanintegratedapproachtoprofessionalhealthcareeducation.
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A compelling need exists among
health care aculty and administrators
to develop a new approach to educating
students in dentistry, medicine, public
health, nursing, and other health
care proessions. The approach must
be integrated, encompassing alldisciplines.
That was the message rom the
Dean o the University o Michigan
Medical School, Dr. James Woolliscrot,
to administrators, aculty, sta, and
students during the School o Dentistrys
ourth annual convocation ceremony in
August. The event celebrates the start
o a new academic year.
In developing a new model o
educating health care proessionals,
Woolliscrot emphasized the importance
o being proactive.
Society is demanding change, he
said. Those involved in health care
must take the lead because i we dont,
government will mandate change, and
mandates may not be what any o us
will be happy about.
Tracing the evolution o health care
education and treatment, he said the
Civil War was a major turning point that
aected educators and the public.
There was an incredible outcry
then about deplorable medical conditions
because o the way soldiers were treated
or their wounds, he said. The outcry led
to a handul o the nations institutions o
higher learning, including the University
o Michigan, to pioneer what turned
By 2015 or 2020, there will only be a few global educational institutions of higher learning.
Others will become regional, specialty education institutions or relegated to oblivion.
out to be major reorms in health care
education and training in medicine,
dentistry, and other proessions.
Those reorms were things that
we as educators now take or granted,
including educational prerequisites,
clinical training, more classroomtraining, and research, he continued.
Because U-M and the other colleges
and universities responded, they survived
and thrived.
For those that didnt, the uture was
bleak.
The colleges and universities that
did not embrace change then, including
many that were prominent at the time,
are now historical asterisks because
they didnt respond or they didnt have
a vision, Woolliscrot said.
That lesson rom the past is the
lesson or today. However, today, medical
and dental schools and other health care
proessionals must be in the vanguard.
A conluence o events, he said,
is driving the need or an integrated
approach to health care at colleges and
universities.
T h e y i n c l u d e c h a n g i n g
demographics, globalization, higher
levels o education, an explosion o
knowledge ueled by advances in
technology, and a growing need to
provide health care that is aordable.
The schools o higher learning were
the drivers o change then, and those o
us here at University o Michigan must
be in the lead today, Woolliscrot said.
Michigan is better positioned than most
institutions o higher learning in the
nation or the world to be a leader in a
new, integrated approach to health care
education.
Urgently Needed:An Integrated Approach to Professional Health Care Education
Dr. James Woolliscroft, Dean, University of Michigan Medical SchoolRemarks at School of Dentistry Convocation, August 2007
iPod Initiative Lauded
Dur ing remarks , Wool l i sc ro f t
applaudedtheSchoolofDentistrys
iPodinitiativethatallowsdental
and dent a l hy g iene s t u dent s
opportunities to listen to classroom
lecturesontheir iPodsorother
portablelisteningdevices.
We at t he Medi ca l S choo l
havecopiedwhatyouhereattheSchoolofDentistryhavedonein
makingourclassroomlectures
availabletoourstudents,hesaid.
I t s a fundamental change in
howstudentslearnthat,Ithink,
will continue or the oreseeable
future.
Woolliscroftsaidhefrequently
has students tell him that they listen
to lectures and other presentations
ontheir iPods,butusuallyatahigherspeed.Theyllsay,Illlisten
atspeedsbetweenone-and-a-half
to two times normal because it
orces me to pay closer attention
towhatsbeingsaid.Butiftheres
somethingIdontunderstand,Ill
gobackandlistenagain.
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Paperless is now a reality in oneSchool o Dentistry clinic.
In late July, the Robert W. Browne
Orthodontics Cl inic completed a
transition rom an environment where
patient inormation, or decades, had
been stored on paper to one that is now
completely electronic.
T h e m o v e i s o n e o m a n y
technological initiatives in recent
years [DentalUM, Fall 2005, pages
4-31].
This is a major milestone or the
School, said Dr. Sunil Kapila, chair
o the Department o Orthodontics
and Pediatric Dentistry, who said the
paperless clinic would be a model as
other clinics throughout the dental
school become paperless in the
uture.
Our aculty, residents, and sta
are now able to electronically retrieve
a wealth o inormation about our
patients instead o having to sit
through mounds o paper, he said.
E v e r y n e c e s s a r y p i e c e o
inormation about each patient,
Kapila continued, including his or
her dental history, appointments,
treatments, radiographs (x-rays),
photographs, payment history, and
more is now available at chairside.
The inormation is accessible at 27computers in the clinic.
Being able to instantly retrieve
inormation, Kapila added, will save
valuable time, beneit patients, and
help those providing oral health care.
Dr. Scott Conley, clinical assistant
proessor o dentistry, coordinated the
Departments eorts with the Schools
Paperless Records, Patient Information
Now a Reality in Ortho Clinic
Department o Dental Inormatics.
Another Important First or U-M
Ho we v e r , t h e r e i s a n o t h e r
important irst worth noting about
the paperless clinic.
According to Roger Gillie, director
o programming services in the Schools
Department o Dental Inormatics,
the School o Dentistry has become
the irst and only unit in the entire
University o Michigan system that
allows aculty members, since theyhave inal authority or patient care,
to access patient records using their
university-approved identiication
card.
They swipe the card in a slot
near the computer monitor the same
way they do when buying something
at a store using a credit card, he
said. However, its important to
emphasize that there are security
measures in place designed to prohibit
unauthorized access.
Gillie and members o his team
installed the hardware during a
weekend in May and then tested the
hardware and sotware, MiDent, or
several weeks.
They also took advantage o new
technology to minimize costs.
Behind each computer monitor is
a Mac mini rom Apple Inc. Aboutseven inches square and two inches
deep, the unit is the smallest desktop
computer marketed by the company
and can be used as a Mac or a Windows
personal computer. Their small size
cuts down the need or counter space
or storage space and cables too, Gillie
said.
The Robert W. Browne Orthodontics Clinic is the rst o the Schools clinics where patient inormation is now available electronically
at chairside. Dr. Sunil Kapila (right), chair o the Depar tment o Or thodontics and Pediatric Dentistry, watches Dr. Scott Conley (let),
who coordinated the depar tments transition to a paperless environment, retrieve a patients records. Roger Gillie (center) led a Dental
Inormatics team that installed the hardware and sotware in the clinic.
Jerry Mastey
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Dental patients suering romacial pain and TMD can get help at
a new acility now being run by the
School o Dentistry in partnership with
the U-M Health System.
The TMD and Oroacial Pain Clinic,
at 325 E. Eisenhower, just north o
Briarwood Mall, is a collaborative
venture that involves the School and
units rom the U-M Health System
including Physical Medicine and
Rehabilitation, the Spine Clinic, andOral and Maxilloacial Surgery.
The U-M Hospitals Medical Pain
Clinic and the Headache Clinic will
be at the same location in the near
uture. Other specialty units rom the
Taubman Center, including neurology,
otorhinolaryngology, and psychiatry,
will also be involved.
Benets to Patients
Patients experiencing TMD and
oroacial pain will have better access
to care and treatment and will ind it
easier or them to be seen, evaluated,
and treated by oral health care and
medical proessionals under one roo.
The Clinic opened earlier this year
to address an unmet need or treatment
among a segment o the population
experiencing TMD and oroacial pain,
said Dr. Paul Krebsbach, chair o theDepartment o Biologic and Materials
Sciences. The Department oversees the
Clinics operations.
He credited Dean Peter Polverini
or launching the new acility and
ostering greater collaboration with
other U-M units.
A Complex Problem
Because o the complexity in
understanding and treating such
complicated conditions , a team
approach that utilizes expertise in
both medicine and dentistry will likely
have the best opportunity or success,
Krebsbach added.
Dr. Lawrence Ashman is the
director o the new clinic. For nearly
thirty years, his general dentistry
practice ocused on evaluating and
managing TMD and oroacial pain.
He will collaborate with Dr. George
Upton in the Department o Oral and
Maxilloacial Surgery who has a long
history o treating TMD patients.
Noting that approximately twenty
percent o the population experiences
some kind o acial pain, Ashman
New Pain Clinic Extends Dental-Medical CollaborationTo Better Serve Patients with TMD & Orofacial Pain
Dr. Lawrence Ashman is the director o the TMD and
Oroacial Pain Clinic. The Clinic is a collaborative venture
that involves the School o Dentistry and units rom the
U-M Health System.
said, temporomandibular disordersand other oroacial pain disorders
are complex clinical problems that
oten involve both dentistry and
medicine.
Because these conditions are
complex, he added, that is why we
need to work closely, not just with
our dental colleagues, but those in
the medical community i we want
our patients to have the best possible
treatment or their pain and avorableoutcomes.
Ashman said the clinic will
always be ocused on patient care.
But because o the inormation we will
be gathering as we help patients, we
may ind, over time, that the Clinics
mission could evolve to encompass
teaching, education, and research, he
said.
When he was at the U-M School o
Dentistry, Dr. Christian Stohler ran a
pain clinic that sought to gain urther
insights into the reasons or a patients
pain. The new clinic is more ocused
on managing a patients pain.
The TMD and
Oroacial Pain Clinic
325 E. Eisenhower
Suite 100
Ann Arbor, Michigan 48108
Telephone: (734) 936-7175
Jerry Mastey
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Dental Scholars Begin 2nd Yearwith Community Service
U-M School o Dentistry Dental Scholars made a major dierence at an Ann
Arbor School this summer.
Their community service painting classrooms, cleaning acilities, and
scrubbing cots helped the Perry Nursery School save about $1,800. We can
now use those unds or our program to purchase educational supplies and
or instructional purposes, said Heavenly Jackson, the schools development
director. Jackson said she and others at Perry eel ortunate to have such
caring partners. Were deeply thankul the dental students were here. Their
generosity and enthusiasm was something to behold. Wed love to have them
back again, she said with a smile.Established in 1934 to help children rom impoverished amilies, Perry
provides aordable high quality schooling, on a sliding ee scale, to approximately
100 children throughout Washtenaw County ranging in age rom 30 months to
our years. The state-licensed school is one o only seven percent nationwide to
be accredited by the National Association or the Education o Young Children.
Students Enthused
In late August, a second class o 14 Dental Scholars joined their colleagues
rom last summers inaugural class with a Friday evening dinner ollowed by
the Saturday morning work at Perry.
The experience was one dental students and aculty members and Perryadministrators will always remember.
This is great, I really enjoyed being here and doing this, said Eric Skulsky
a second-year dental student and member o the irst class o Dental Scholars.
Ben Anderson, another second-year Dental Scholar agreed. This was cool,
he said. I really enjoyed being able to help.
Dr. Robert Eber, who was one o several School o Dentistry aculty members
who helped, was surprised with how much was accomplished in three hours.
Dental Scholars:
Overview
L au nc hed in 2006, t he S c ho lar s
Program in Dental Leadership, as its
ormally known, brings together a
select number o exceptional students
with diverse backgrounds to help
them develop a leadership mindset
and the skills they can use to promote
change in dentistry, dental hygiene,
education research, or academia.
More inormation is on the School
o Dentistry Web site: www.dent.umich.edu/prospective/spdl.
(let): James Skousen, Thao Le, and Hannah Budzinski paint a
hallway outside a classroom at the Perry Nursery School.
(above): Dental hygiene students Maria Alspaugh (let)
and Audrey Stratz cleaned dozens o sleeping cots. In the
background is Anne Gwozdek, adjunct dental hygiene clinical
lecturer and a Dental Scholars mentor.
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Its amazing how much you can dowhen so many people are working
together at one time, he said.
Outdoor Team Building Exercises
Ater lunch, boarding a bus, and
traveling to the U-M Recreation Area,
Dental Scholars participated in several
outdoor activities that challenged them
to reach a goal through communication,
collaboration, adapting to change, and
leadership.M o s t o t h e t i m e , s t u d e n t s
participated in groups o eight or nine.
In one activity they were challenged
to cross an imaginary river, hemmed
in by electric ences, using only two
crates, two boards, and a small pole.
However, their inal outdoor
activity challenged all o them.
One by one, the Scholars stepped
onto a long plank that represented a
boat. Beneath the plank in the center,
was a board that made the boat teeter
when it was unbalanced. At each o the
our corners were small, air-lled balls
that would squeak when that occurred.
When the Dental Scholars heard a
squeak, all o them had to get o the
plank, reassess their strategy, and then
reboard. They had just 30 minutes to
develop a successul plan.
Even more challenging was thatthey were not allowed to speak as they
approached the plank or once they
were on it. Communicating was done
using hand signals. Ater several alse
starts and subsequent collaboration
the Scholars succeeded in reaching
their goal.
A Transormation
TheworkofDentalScholarsimpressedPerryNurserySchooladministrators,
includingfamilyservicesdirector,MaryFabirkiewicz.Thephotosaboveshowa
roombeforebookcasesweremovedfromthecenterofaroomtowallssochildren
couldmoveaboutfreely.Theresultsoftheirworkareevidentinthephotoonthe
right.Wow!Whatatransformation!Fabirkiewiczexclaimedasshewalkedinto
theroom.Icantbelievewehavesomuchspaceagain.Itswonderful!
DentalScholarsalsofoundwaystohavesomefun.Aftercleaningoneclassroom,somefoundsunglassesandposedforthisphoto.
Picturedlefttorightare:RobertWiesen,DarleneOccimio,SaraArnold,KeithDobracki,JuliaLatham,EricSkulsky,MeganDubois,
LindsayRayburn,andKarenJanusz.
Jerry MasteyJerry Mastey
Jerry Mastey
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Zahid Ahmed
Maciak Dolata
Christie Springstead
Robert Wiesen
Irene Haddock
MalijeOnwueme
Eric Skulsky
New Dental Scholar Julia Latham balances hersel on one board as she begins placing a second across
an imaginary river during Dental Scholars challenge activities. Mansi Goyal (let) and Sarah Miller
(right), with the U-M Challenge Program, are ready to catch Latham should she all.
James Skousen (let) and Jason Schrotenboer use hand signals to communicate with Dental Scholars
on how to position themselves so the plank, representing a boat, did not capsize.
Stephanie Nuez (D1)Meghan Dubois (D1)
Julia Latham (D1)
Lindsay Rayburn (D1)
Javana Cosner (D1)
Victoria Lucas-Perry (D1)
Elizabeth Caplis (D1)
Jerry Mastey
Dr.Russell Taichman
New Dental Scholars
Stephanie Munz (D1)Karen Janusz (D1)
Michael Barber (D2)
Sara Arnold (D2)
Robert Wiesen (D2)
Malije Onwueme (D3)
Maria Alspaugh (DH3)
These photos, taken by Dr. Russell Taichman,
director of the Dental Scholars program, show
some of them at work and having fun at the
Perry Nursery School.
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New Field, New Opportunities BiodonticsBlending Dentistry, Business, Innovation, and Technology
Personal computers. The WorldWide Web. The Internet.
When these words and phrases were
spoken or appeared in print or the rst
time, most people scratched their heads
wondering what PCs, the Web, and the
Net were all about.
Is history repeating itsel? Maybe.
Consider the early years o the
Twenty-First Century.
Heres a word you probably havent
seen in print or heard about beore biodontics.
What is biodontics, you ask?
Basically, its an emerging ield
o study that encompasses several
disciplines clinical dentistry, research,
business , entrepreneurship, and
technology. The goal o biodontics is to
try to determine what innovations rom
a biological research laboratory may one
day be combined with technology.
The ultimate goal o biodontics is
to commercialize products that dentists
can use in their clinics and, in the
process, improve the oral health o the
population at large.
Earlier this year, a number o
U-M School o Dentistry aculty,
administrators, and Dental Scholars
met to learn more about the emerging
eld and even come up with some new
ideas o their own.Biodontics is a relatively new
eld.
It was created only six years ago
by Dr. Edward Rossomando, a proessor
at the University o Connecticut School
o Dental Medicine. He spoke during a
spring weekend program at the Michigan
Center or Oral Health Research.
During the program, the Dental
Scholars and others worked in small
groups to brainstorm and develop ideas
that, someday, could become reality in
the dental proession.
The groups were pretty creative,
said Dr. William Giannobile, proessor o
dentistry and MCOHR director.
Some o the ideas included using
the Internet to deliver instant messages
in the handle o a toothbrush to remind
patients o dental appointments or
give them important oral health
inormation.
It was an interesting program that
was designed to spur creativity anda sense o business entrepreneurship
in the students, said Dr. Russell
Taichman, director o the Dental Scholars
program.
Biodontics: Primary Goals
Developeducational,translational
research,andclinicaltrialsprograms
designedtointegratebasicscience
discoverieswithclinicalapplications.
Encouragethedevelopmentof
novelapproachestoclinicaland
translationaltraining.
Provideauniversity-based,objective
testingandevaluationprogramfor
dentalmanufacturers,distributors,
andlaboratoriesperformedin
state-of-the-artfacilitiestoensure
thehigheststandardsofevaluation
throughitsproducttestingdivision.
Provideauniqueopportunityfor
dentalmanufacturinganddistribution
companiestopresentproductsto
dentalstudents,residents,andfaculty
inafocused,structuredsetting.
Providedentalmanufacturinganddistributioncompaniesaccessto
multipleprogramsthroughits
associatemembershipprogram.
Source:www.biodontics.org
Dr.William Giannobile
Darlene Occimio (let) listens to a presentation by Jason Schrotenboer during the biodontics program. Next to him are
Eric Skulsky and Christie Springstead.
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Evidence is growing that the
dentists role as a health care provider
has become increasingly important to
their patients.
Oral health and general well-
being are inextricably linked as noted
by the act that many conditions
plaguing the body are maniested
in the mouth, Dr. Kitrina Cordell
told members o the Norman Mette
Foundation Board o Directors during
their annual spring meeting at the
School o Dentistry.The groups meeting marked the
17th consecutive year that more than
a dozen members o the board came to
the University o Michigan School o
Dentistry and the U-M Health System
to learn more about advances in oral
health care, medicine, classroom and
clinical education, and research.
Cordell, an oral and maxilloacial
p a t h o l o g i s t , c l i n i c a l a s s i s t a n t
proessor, and associate director o
the Schools oral pathology biopsy
service, brieed the group about the
growing awareness o relationships
between oral health and systemic
disease. [See sidebar, page 15.]
Dr. Russell Taichman, proessor o
dentistry and director o the Scholars
Program in Dental Leadership, also
addressed the group, describingdiscoveries about l inks between
periodontal disease and heart disease
and diabetes.
The Mouth as an Early Warning
System
We constantly emphasize to
our students, in both classrooms andclinics, that they are not just dentists,
theyre also health care providers,
Cordell said.
Underscoring that point, she
cited a report rom the U.S. Surgeon
Generals 2000 Report on Oral Health
that noted the mouth can unction as
an early warning system or some
diseases and that early identiication
o oral disease can contribute to
diagnosis and treatment o systemicdiseases.
The general dentist is on the
ront l ine o the de ense o ora l
disease, she said. Since not all
patients receive regular medical
care, the dentist may be the irst to
diagnose a systemic disease based on
oral indings.
S h e s a i d t h a t d i s e a s e s c a n
b e d i a g n o s e d d u r i n g c l i n i c a l ,
r a d i o g r a p h i c , m i c r o s c o p i c ,
biochemical, or other examinations.
Taking a patients blood pressure
was cited as one example.
In response to a board members
question, Cordell said all dental and
dental hygiene students routinely
take a patients blood pressure and ask
about the health history o patients
treated in the Schools clinics.
Pointing to research cited bythe National Institute o Dental
and Cranioacial Research, Cordell
said that periodontal disease may
exacerbate existing heart conditions
and that people with periodontitis
may be more l ike ly to deve lop
cardiovascular disease than those
Oral Health-Systemic Health Links DescribedMette Foundation Board Learns More During Dental School Visit
Dr. Kitrina Cordell outlines links between oral and systemic health to members o the Norman Mette Foundation
during their annual visit to the School o Dentistry.
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This is a key study that shows
how periodontal disease may aect
systemic health.
Taichman added, Other clinical
studies and some laboratory studies
are showing that diabetes seems to
be a major risk actor or periodontal
disease. Im emphasizing the word
seems because we have yet to prove
a link between the two. Its diicult
to do because research is both time
consuming and expensive.
without periodontal inection.
C o r d e l l a l s o n o t e d t h a t
systemic lupus erythematosus has
cardiovascular implications such as
increased atherosclerosis, as well as
other systemic implications that canbe potentially lie threatening.
From Early Suspicions to Todays
Research
Taichman discussed some o
the oral/systemic links, including
diabetes and periodontal disease.
One observation he shared with
board members was rom a sailors
diary nearly our hundred years ago
as he circumnavigated the globe with
Ferdinand Magellan in 1520:
We entered the Pacific Ocean,
3 months and 20 days without
fresh food of any kind. The
gums of the upper and lower
teeth of some of our men were
so swollen that they could not
eat under any condition. 19 of
our men died.
Even back then, we had some early
suspicions about possible connections
between oral and systemic health,
Taichman said, because the condition
described then, compared to what we
know now, was most likely due to a
lack o suicient vitamin C.
Taichman said he believes the
Rosetta Stone that points to possible
denta l and sys temic l inks was
discovered more than a decade ago,
in 1994, by the School o Dentistrys
Dr. Walter Loesche. Loesche and
others investigated the oral and
systemic health o more than ive
hundred individuals at the Veterans
Administration Hospital in Ann
Arbor.
In a nutshel l , the research
showed that those with periodontitis
were about three times as likely to
have coronary disease, he said.
Studies have shown a relationship between dental
disease and: Systemic infect ions
Cardiovascu lardi sease
Diabetes
O steopo ro si s
Part o the observed associations may be compounded by:
Smoking
Stress
D ie ta ry i ntake
Behavioralfactors(selfcare,professionalcare)
Association Between Dental and
Systemic Disease
We constantly emphasize to our students, in both
classrooms and clinics, that they are not just dentists,theyre also health care providers.
Dr. Kitrina Cordell
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The Gateway to Better Oral HealthBegins Herethe PAES Clinic
Here is a sound I know youre looking orward to hearing, Dr. David
Jacobson says jokingly, drill in hand, to patient Amanda Shaer as she settles
into a dental chair in the School o Dentistrys Patient Admitting and Emergency
Services (PAES) Clinic.
Shaer has come to the Clinic or treatment o a ractured tooth.
My mother told me about what the dentists and dental students do hereto help patients and urged me to come to get this taken care o. So here I am,
she says with a smile.
A ew minutes earlier, Jacobson, the Clinics director, introduced himsel,
asked Shaer questions about her condition, and explained what he would be
doing to help.
Moments later, Shaer hears the whirring sound o a drill as Jacobson begins
his work.
During the next twenty minutes, he requently pauses to ask questions,
usually to determine i Shaer is eeling any pain and i shes comortable. He
also takes time to explain what will happen next.
When he inishes, Jacobson asks Shaer to look at a hand-held mirror hegives her. She looks into the mirror, opens her mouth, checks her teeth, smiles,
returns the mirror, and thanks Jacobson or his help as she gets up and leaves
the Clinic.
A Very Busy Place
Shaer is one o thousands o patients who come to the PAES Clinic each
year or oral health care.
In recent years, the number o patients seen at the Clinic has consistently
exceeded 11,000 annually. [See chart page 17.]
Dr. Stephen Steanac, associate dean or patient services who oversees
the Clinics activities, says the Clinic, more oten than not, is a very busy
place.
Between 50 and 60 patients are seen daily. However, there have been times
when those numbers have been higher. A record 99 patients were seen on a
single day in late February 2003. Although he doesnt remember the reasons or
the surge, Jacobson says, because o the work o the sta, their commitment,
and the loyalty o the students, we were able to help every one o the patients
who came here that day.
D e n t a l S c h o o l s H o s p i t a l E m e r g e n c yRoom Helps Pat ients from across Michigan
Amanda Shaer looks at a
mirror to check the work
Dr. David Jacobson did or
her in the PAES Clinic.
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Its a demanding environment,
even in the best o times, or Jacobson
and two other ull-time sta dentists
Drs. Vernon Rie and Juan Johnson and
part-time dentists Drs. Justin Dugas,
Aaron Ford, and John Seago.
Located on the irst loor o the
dental school, the Clinic is the gateway
to better oral health that serves the
public in two important ways.
One is to help patients who need
emergency care, typically walk-in
patients who do not have a scheduled
appointment, but need prompt attention
to alleviate pain. As the chart shows,
the PAES Clinic has treated more than
5,000 patients annually in this category
or the past our years.
The other is to screen patients
seeking comprehensive care who are
interested in receiving longer-term, on-
going treatment at the dental school.
More than 6,000 patients annually are
in this category.
Emergency Care
When a patient needing emergency
care arrives, Jacobson, or two other
sta dentists, and ourth-year dental
students, spend time listening to the
patient and asking questions about
their condition.In emergency situations, patients
are told that only their particular
problem will be addressed.
Our objective is to get the patient
out o pain, Jacobson says. But on any
given day, he adds, about hal o our
walk-ins are reerred to oral surgery
or extractions.
Some o these patients, Jacobson
says, involve an alarming number o
young people with rampant caries due to
their consumption o soda pop and other
sot drinks. [See sidebar, page 21.]
Other patients, however, may
be reerred to other clinics such
as periodontics or orthodontics or
endodontics or speciic procedures.
It is not uncommon during the
course o an emergency examination
or a patient to be told that he or she
will need comprehensive care that will
have to be provided over an extended
period o time.
Comprehensive Care
The PAES Clinic screens every new
patient who makes an appointment to
receive long-term comprehensive care.Although many o these individuals
are new patients, there are some who
have not been to a dentist or some
time, in some instances, ive or even
ten years.
When irst-time patients arrive,
they watch a new six-minute video that
describes what they will experience
and how the Clinic works.
A signiicant portion o the initial
screening amounts to what Jacobsondescribes as a ree consultation.
Each patient receives a cursory
examination to see i there are
any problems that might require
immediate treatment and a screening
examination or oral cancer. I there
are no immediate problems, the
inormation that is gathered is used to
assess the patients needs and discuss
what needs to be done. Emergency
radiographs are also ordered, when
necessary, or the PAES Clinic.
However, these new patients do
not receive any preliminary treatment.
Instead, they are assigned to a dental
student in one o the Schools our
comprehensive care clinics.
For the past our years, more than 11,000 patients annually have come to the School o Dentistry s PAES
Clinic to receive oral health care. Many live within a 30- or 40-mile radius o Ann Arbor. However,
others drive two, three, our, and sometimes ve hours to receive care.
PAES Clinic Patient Visits
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The clinics give students in allour dental classes and the three
dental hygiene classes opportunities
to work together , with aculty
supervision, to achieve high levels o
clinical experience and competence.
Also known as Vertically Integrated
Clinics, students obtain basic clinical
training that prepares them or more
advanced clinical experiences during
their inal years in the dental and
dental hygiene programs.However, patients may also be
reerred to a specialty clinic.
Regardless o whether a patient
is treated in a specialty clinic or a
comprehensive care clinic, they are
told about the major dierences
between being treated at the School
and a private practice.
We emphasize to patients that
because we are a teaching acility,
everything will take longer than it
would in a private oice, Jacobson
says.
However, they are happy to
learn that the School s ees are
approximately one-hal o what area
dentists and specialists charge or the
same procedures, he adds.
Providers o Last Resort
Many patients who come to thePAES Clinic live within a 30- or 40-mile
radius o Ann Arbor.
However, others drive two, three,
our, and sometimes ive hours to
receive care. Those patients typically
come rom the western part o the
state , the Upper Peninsula, and
northern lower Michigan. A ew even
come rom outside Michigan.
W i t h M i c h i g a n s e c o n o m y
what it is now because o corporate
d o wn s i z i n g s , e s p e c i a l l y i n t h e
automobile and automotive supply
industries, were seeing more patients
than ever who have nowhere else to
go to be treated or their conditions,
Steanac says. In many instances,
were the providers o last resort.
Compounding the problem is
that, in recent years, many oral
health care providers have decided
not to oer dental care to Medicaid
patients because their cost to do so,including supplies, substantially
exceeds reimbursement rom the
state.
A c c o r d i n g t o t h e M i c h i g a n
Department o Community Health,
the number o Michigan dentists
accepting Medicaid payments has
declined 39 percent, rom 1,578 in
2000 to 961 currently. Only about 15
percent o the states 6,500 dentists
take Medicaid.
The state currently spends about
$8 billion on Medicaid, nearly twenty
percent o its budget, to provide
health care coverage, including dental
care, to about 1.46 million low-income
children, adults, and seniors. O that
amount, approximately $80 million,
or one percent o the budget, is or
dental-related services.
G i v e n t h i s c o n l u e n c e o
developments , it is common or
p a t i e n t s s c h e d u l i n g t h e i r i r s t
appointment to wait six to eight weeks
or initial visits that are required prior
to receiving comprehensive care.
Student/Sta Dentist Teamwork
The PAES Clinic, though, is not just
a treatment acility. It provides dental
Fourth-year dental student Brian Shaughnessy (let) discusses his plans to treat a patient who has come to the
PAES Clinic or emergency oral health care with PAES Clinic Director Dr. David Jacobson.
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students with learning opportunities
while oering services to patients,
many o whom eel they have no
where else to go.
Fourth-year dental students are
required to be in the Clinic or at least
10 hal-day sessions. They triage,
examine, and administer emergency
care to walk-in patients.
However, dental students in other
classes may visit and observe as oten
as they wish.
We want the ourth-year students
to see as much pathology as possible,
Jacobs on says . In act , th e sheer
volume o patients who are treatedhere insures students will see cases
they generally dont experience in one
o our comprehensive care clinics.
Dental students agree. [See story,
page 22.]
Sta dentists attempt to rame
each experience in the context o
how it might be handled in a private
practice.
Jacobson wi l l o t en present
students with this situation: Suppose
youre in the middle o a crown prep
and a patient walks in at which
point he describes other activities
occurring in the dental oice that
need resolution.
We want students to look at these
urgencies with a creative problem
solving mindset, he says. Its not a
case where there are necessarily right
answers. Instead, we would like them
to consider a number o options rom
which to choose, he says.Jacobson, Rie, and Johnson work
with the dental students. More oten
than not, however, they keep a low
proile so the dental student learns
how to manage the psychology o a
patients pain rom the moment they
greet the patient. The reason or this
approach is to allow each student todevelop their skills, increase their
comort level with diicult issues,
and, ultimately develop their own
style.
But when a procedure is beyond
the scope o a students training,
sta dentists are there to perorm
the treatment. In these instances, the
student will watch, or perhaps assist
a sta dentist. However, in similar
uture cases, they are expected to domore.
Were there as a saety net or the
dental students and we know when
to intervene, Jacobson says, but
we want each to develop their own
style and their own way o working
with a patient. That includes
explaining their indings, diagnoses,
and discussing treatment options
with each patient.
The sta dentists say all o these
experiences make it easy to remain
enthusiastic.
I t h o r o u g h l y e n j o y t h e
opportunity to practice dentistry
here at Michigan, teaching students in
the Clinic, working with aculty, and
handling a large variety o patient
cases, Dr. Juan Johnson says.
D r . V e r n o n R i e , wh o i s i n
private practice, but once thoughtabout becoming a teacher as an
undergraduate, says, the opportunities
I have daily to educate new patients
who come to our Clinic or treatment,
as well as mentoring the dental
students who help here, is the best o
both worlds.
Dr. Juan Johnson and ourth-year dental student Nathera Balachandran review radiographs and discuss options
to treat a patient receiving care.
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Crucial Collaboration
Playing a major role in the successo the PAES Clinic are the Schools
patient care coordinators (PCCs).
T h e s e i n d i v i d u a l s a r e
intermediaries between the students
and the patients. They work with
the clinic directors to ensure that all
patients receive the care they need,
and that the students get the support
and experiences they need to become
competent and are prepared to take
state-required licensing examinations
prior to graduation.
Jacobson , R i e , and Johnson
requently work with the coordinators
to help patients and dental students.
Dental students who learn o an
appointment cancellation by one o
their patients have an opportunity
to ill their empty chair.
Working with the PCCs, the PAES
sta matches those students looking
or work with patients needing
help. That dental student may be
able to proceed immediately with
a comprehensive oral exam and
treatment plan that otherwise would
occur during the patients next
visit, Jacobson says. Its a win-win
situation. We save the patient a visit
and provide a student with a learning
and treatment opportunity.
The PAES Clinic maintains an
open door policy. Anytime a dental
student has ree time and is looking
or something to do, they can stop
at the PAES Clinic. The patient care
coordinators have allowed us to try
this out, and it works, Jacobson
says.
With all the activity in the Clinic,
Jaco bson says , we are consta nt ly
measuring and trying to improve
what we are doing here.
Its an exciting time to be here
in the PAES Clinic, he adds. We
have received a lot o support rom
Dean Peter Polverini, patients tell
us they appreciate receiving the
quality o care theyre getting, and
the interaction with the students
continues to be highly rewarding. For
me, its incredibly gratiying whenyou can both help a patient and teach
a student something new about the
art and science o dentistry.
Dr. Vernon Rie adjusts a patients denture ater the
patients mandible was ractured in an accident makingit dicult to use. The adjustments allowed the patient
to use the denture until a new set o custom-made
dentures was available.
Jerry Mastey
Located on the rst oor o the dental school, the PAES Clinic isthe gateway to better oral health that serves the public in two
important ways. One is to help patients who need emergency
care. The other is to screen patients seeking comprehensive
care who are interested in receiving longer-term, on-going
treatment at the dental school.
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A headrest that attaches to wheelchairs makes it easier or
both the patient and the dentist.
Although most patients seen at the PAES Clinic can walk into the Clinic
without assistance, there are those who cant, primarily patients in wheelchairs.
Their special needs are being accommodated.
A special cubicle is available or those patients. In addition, a device is
being used that makes it easier or both the patient and the dentist.
The new device is a dental headrest. Its clamped to the handles o a
wheelchair so these patients dont have to be physically transerred rom their
wheelchair to a conventional dental chair. The headrest allows patients to
comortably tilt their heads backwards.
We want our students to get more experience treating special needs patients
so they develop a sense o comort and acceptance that will carry over to their
private practice, says Dr. David Jacobson.
In May, 48-year-old Michael Flynn arrived in a wheelchair needing emergency
treatment. When he was 16, Flynn broke his neck and severed his spinal cord
in a diving accident.
Jacobson perormed a pulpectomy on Flynn, much to his relie. When it was
over, Flynn thanked Jacobson telling him, that was a very painless procedure.
Very well done. Youve made my day, I appreciate that, Jacobson said as
Flynn let the Clinic.
Soda+
Caries =An Alarming Problem
Analarmingproblemweseein
patientsthatcometousforcare
iscariescausedbytheexcessive
consumptionofsodaandothersoftdrinks,saysClinicdirectorDr.David
Jacobson.
Jacobsonsaysthatheanddental
studentsintheClinicstillheara
prevalentmythfrompatientsthat
low-calorieorno-caloriesoftdrinks
donotcausecavities.Manybelieve
thatifthereisnosugarinthediet
soda,itslikedrinkingwater,he
adds.Whenwehearthat,wetell
thepatient,Thatdefinitelyisnotthecase.Intheseinstances,theculprits
arecitricacidandthephosphoric
acidinthedrinks.
Whenitcomestocausingcaries,
Jacobsonsaysthatonascaleof
zerotofive,withwaterbeing
zero,regularsodapopisfive,but
patientsarereallysurprisedtolearn
dietsodaisthree.
Wetellpatientsthatthey will get
caries,butthatitwilltakelongerthaniftheydrinkasugar-laden
beverage,hesays.
Intheirroleaseducators,PAES
Clinicdentistsanddentalstudents
encourageallpatientstoreadsoft
drinklabels.
Accommodating Special Needs
Patients
A special cubicle in the PAES Clinic allows patients using
wheelchairs to be treated.
Jerry Mastey Jerry Mastey
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DENTISTRY
Fourth-Year Dental Students Say PAES ClinicA Very Valuable Experience
Fourth-year dental student Sarah
Miller says she eels more conident
diagnosing and dealing with patients
who have emergency dental needs
ollowing her experiences in the PAES
Clinic.
Instead o taking a month o
between the end o her third year
and the start o her ourth year in
the predoctoral program, Miller chose
to work in the PAES Clinic two days
a week. She did so to learn more
about the types o cases the Clinic
handles and also learn more about the
admitting process or new patients.
The Clinic was much aster
paced, and I saw more patients than
usual, sometimes about ten a day, she
said.
Fourth-year dental student NatheraBalachandran agreed, adding the
range o treatments patients needed
was revealing.
More Variety
Theres a lot more variety in the
PAES Clinic that you dont see in the
comprehensive care clinics, she said.
Balachandran said she oten came
to the Clinic as a third-year student
when some o her patients didntshow up or their appointments in the
comprehensive care clinics.
In addition to learning more about
emergency dental situations, Miller said
she too observed and helped patients
with a range o dental problems.
Some were minor, like questions
about bruxism or temporaries alling
o, but there were some major traumacases, she said.
One major trauma case involved
two anterior tooth avulsions with
maxillary alveolar racture and nasal
racture. I learned there are many
ways o dealing with a case like this,
as well as many actors that go into
the prognosis o an avulsed tooth,
she said. Because o the severity o
the case, the patient was ultimately
reerred to the hospital or ollow-uptreatment and care.
Mostly, however, Miller said she
saw and treated patients with a
range o endodontic problems. Some
had reversible pulpitis. Others were
irreversible. And there were many
patients with cases o pulpal necrosis.
Up to this point, I had not seen an
endodontic case within my patientpool in the comprehensive care clinic,
and had no real dental emergencies to
speak o, she said.
Millers experiences with dental
emergencies in the PAES Clinic instilled
conidence. Im much more conident
in testing, diagnosing, and giving a
patient all the options available about
their speciic problem, she said.
Her PAES Clinic experiences were
beneicial or another reason.It also allowed me to see what it
was like to be in a more real lie setting
with numerous patients to examine
and care or, she said. I eel much
more conident o my skills diagnosing
and dealing with emergency dental
problems as a result.
Fourth-year dental student Sarah Miller and PAES Clinic sta dentist Dr. Juan Johnson review a patients
radiographs to try to locate the source o the patients oral pain.
Jerry Mastey
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DENTISTRY
Medical Residents Learning About Dentistry First-Hand
The medical proession is gaining a better understanding and appreciation o the importance oral health plays ina patients overall health and well being.
For the past year, several medical residents rom the U-M Hospital have come to the dental school to learn more
about how to deal with common dental emergencies they oten see in the hospitals emergency room.
This is an elective or them, so its totally voluntary i they want to be here, and theyre ree to come and go as
they please, said PAES Clinic director Dr. David Jacobson.
However, he continued, most ind the time they spend with dental students in our clinic and with specialists in
our oral surgery clinic is very inormative and helpul.
Jacobson said he, along with Drs. Vernon Rie and Juan Johnson and dental students, try to help the medical residents
recognize the reasons or a patients pain and oer advice on choosing the proper medication when necessary.
Were ocused on the basics, primarily, how to help the patient and get him or her out o pain, Jacobson said.
Kurt Hessen, MDDr. Kurt Hessen, now in the second year o his our-
year residency program at U-M Hospital, spent about
two weeks at the dental school earlier this year.
It was a great learning experience, he said, not
just in the PAES Clinic, but also in the oral surgery
clinics at the hospital and the dental school.
Hessen said he and others see a air amount o
pain with patients who come to the U-M Hospital,problems like ractured teeth, pain rom cavities,
and things like that. So learning more about these
conditions and what we as physicians might be able
to do in these cases was a great learning experience,
he said.
Hessen said he also learned, rom watching
dental students and their clinical supervisors, how
important it is or emergency room physicians to ask
patients about their oral history and any medications
they may be taking.
Brett Russell, MDNow in the third year o his our-
year residency program at U-M
Hospital, Dr. Brett Russell said, We
see just about everything in the
hospitals emergency room, but
having this opportunity to ocus on
dental-related emergencies was very
helpul to me.Russell said he was surprised at just how awesome
the PAES Clinic is and what the sta dentists and dental
students do to help patients in pain. In addition to
observing what takes place in the Clinic, Russell also
spent time in the Schools oral surgery clinic.
The experiences, he said, helped him recently
evaluate a patient who came to the hospitals
emergency room complaining o pain.
Russell said that probably the most important thing
he learned during his two weeks at the dental school
was becoming amiliar with the dental blocks that areused to help patients in pain.
He said he also learned important lessons about
distinguishing between patients who are truly in pain
and need some kind o medication to lessen that pain
and those who may be complaining o pain but, upon
urther questioning and examination, are not in pain
and may be trying to obtain a prescription or other
purposes.
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DENTISTRY
It gives us more time to devoteto the other unctions o the PAES
Clinic while also precisely conveying
the same inormation to everyone
who seeks comprehensive care as a
new or returning patient, said Dr.
David Jacobson o a video all new
patients see moments ater arriving
at the PAES Clinic.
Produced by Jacobson with help
rom the Schools Digital Learning
Laboratory, the six-minute videoincludes still photos with Jacobson
explaining in detail what patients
can expect.
He begins with an overview o the
Schools dental education program
and how the dental students in the
PAES Clinic work with patients ,
under aculty supervision, to provide
care; the process o treatment, that
begins with a comprehensive oral
exam; the treatment options that are
available to a patient ollowing their
visit; and inormation about ees and
payment options.
Time vs. Cost Tradeos
Everything a student does must
be evaluated and approved by a
clinical instructor, Jacobson says in
the video. He notes that students are
required to stop at prescribed pointsand ask an instructor to check and
evaluate their work. As a result,
he adds, this is a time-consuming
process where appointments can
oten last up to three hours.
However, in return or their
time, Jacobson says that patients are
compensated with lower ees that
2 New Videos Produced for PAES Clinic
are about hal o what a private
dentist in this region would charge
or the same procedure.
Beore their treatment begins,
patients are told a comprehensive
oral examination is required. It
includes taking blood pressure and
radiographs, i necessary; compiling
inormation about the patients
medical and dental history; checking
t h e p a t i e n t s h e a d a n d n e c k ;conducting an oral cancer screening;
and assessing the patients oral
hygiene.
In the v ideo , Jacobson te l l s
patients there is no charge or a
brie screening exam or a limited
consultation with a sta dentist they
will receive.
The screening , which takes
less than ive minutes in most
cases , de termines the pat ient s
overall needs and treatment options.
The vast majority o patients are
assigned to predoctoral students
i n t h e S c h o o l s c o m p r e h e n s i v e
care clinics. However, others may
be reerred to one o the Schools
graduate specialty programs, such
as orthodontics or periodontics, or tothe Dental Faculty Associates Clinic,
a acility in the School where aculty
members with dental or specialty
degrees treat patients.
Krystal Gore and her ather, Larry, watch a video that explains what takes place in the PAES Clinic and what
patients can expect when they are treated.
Jerry Mastey
First Video Offers Patients Valuable Information
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DENTISTRY
We want all o our ourth-year dental
students to get an idea o how closely the
PAES Clinic mimics what goes on in a private
practice while also giving them an idea o
what to expect beore actually setting oot
in this Clinic.
Thats how Dr. David Jacobson, PAES
Clinic director, describes a new hal-hour
video ourth-year dental students must
watch beore beginning their rotation inthe clinic on the main foor at the School o
Dentistry.
Crediting Dr. Stephen Steanac with
bringing us into the Twenty First Century as
dental educators, Jacobson says the video,
now being used or a second year, has been
benecial.
Previously, we would present an
orientation to each new group o ourth-
year dental students, he adds, but that
slowed down taking care o patients andalso raised the possibility o omitting some
vital inormation.
As part o their video orientation, dental
students also receive a list o questions to
answer beore their irst rotation.
The video has been so well received that
Jacobson also sends it to third-year dental
students to encourage them to stop by the
Clinic to observe or lend a hand.
Words o Wisdom and Suggestions
The psychology o the patient in pain
is something you will be managing rom the
moment you say hello, Jacobson tells the
students in the video.
These patients will pick up on your
cues. They are looking or a sense that
Second Video Tells Dental Students What to Expect
you have seen their distress beore, that you
know what it is, that you know what youre
going to do about it, that they are in good
hands, and that youre going to get them
out o pain, he adds.
S t u d e n t s a r e t o l d t h a t t h e i r
responsibilities involve data gathering,
including inormation about a patientsmedical and dental histories, conducting
diagnostic tests, making a diagnosis,
explaining the diagnosis, and discussing
treatment options.
However, beore explaining their
indings to a patient, Jacobson advises
students to choose their words careully.
Because they will not treat most o those
patients themselves, students are advised
not to make any promises that other
students or departments have to keep.
Although three sta dentists are
available to help, Jacobson says, As time
goes on, we hope that you will gain an
awareness o your progress and development.
Ultimately, we want you to be able to reer
to yoursel as doctor with conidence.
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DENTISTRY
Dr. Juan Johnson
Sta Dentist
IthoughtIwouldbehereforayear,perhaps
twoatmost,butnowitsbeentenyearsand
Imstillenjoyingmyself,saidDr.JuanJohnson
(DDS1991).
Ienjoy theopportuni ty to pract ice
dentistryatMichigan,teachstudentsinthe
Clinic,workwithfaculty,andhandlealargevarietyofpatientcases,headded.
Althoughheworksfortyhoursaweekin
thePAESClinic,Johnsonalsohasapart-time
privatepracticeinAnnArbor.
Raisedon the is landof Ok inawaand
uentinJapanese,Johnsonsaidhisinterestin
dentistrybeganinhighschool.
OnOkinawa,Italkedtomanymilitary
dentistsandlikedthefacttheyhadalevelof
autonomywhilepracticing,hesaid.
Johnsonalsothoughtaboutbecoming
aghterpilot,buttheyewwhereandwhen
theyweretold,hesaid.WhenItoldthemIwasalsoconsideringdentistry,theysuggested
becominga dentistandearninga private
pilotslicensesoIcouldywheneverIwanted.
Johnsonhasntobtainedaprivatepilotslicense,
butdoesreturntoOkinawaeveryyeartospend
timewithhisfamily.
JohnsoncametoU-Mforhisbachelors
degreeandthenadentaldegree.Fortherst
twoyears,hepracticeddentistryinapublic
healthclinicandthenlearnedabouttheneed
forastaffdentistinthePAESClinic.Iwas
veryinterestedinworkinginPAES,especiallysinceIknewthedirector,Dr.DavidJacobson,
Johnsonsaid.Wehavemanysimilarinterests
andthatmakesbeingintheClinicevenmore
enjoyable.
Whenhes not practi cing denti stry,
Johnsonenjoysrunning,playingbasketball,
chess,andhisbiggestpassion,golf.Youmight
saydentistrysupportsmygolfhabit,hesaid.
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DENTISTRY
Dr. Vernon Rife
PAES Clinic Dentist
IvebeenadentisthereinthePAES
Clinicsince1993andcontinuetoenjoy
theinteractionwiththepatients,helping
themunderstandtheirdentalcondition,
discussingoptimaltreatmentplans,andreferringthemtothoseintheSchoolwho
canbesthelpthem,saysDr.VernonRife.
Afterearninghisdentaldegreefrom
U-Min1975,Rifepracticeddentistryfor
18yearsinHartland,Michigan,before
returningtohisalmamater.
Ien joyeddent is try,but d is liked
doingthepaperwork,makingthehiring
decisions,andalltheotherthingsthatarea
partofaprivatepractice,hesaid,sowhenI
learnedoftheneedforastaffdentisthere,
IappliedandsoldmypracticeonceIacceptedthejobhere.
Rifesaidheenjoysanotherpartofhis
workinthePAESClinic,teaching.
Ithoughtaboutbecomingateacher
whenIwasanundergraduate,orperhaps
workinginmedicineordentistry,hesaid.
TheopportunityIhavedailytoeducate
newpatientswhocometoourclinicfor
treatment,aswellasmentoringthedental
studentswhohelpthepatientsinthePAES
Clinic,isthebestofbothworlds.
When h es no t a t t he Sc hool of
Dentistry, Rifeworks part-timeat a privatepracticeinBellevilleanddirects
amenschorusathischurchinHighland,
Michigan.Ialsodirectavolunteerchoir
atChristmastime.Ivebeensingingsince
Iwasingradeschoolandstillhavealotof
fundoingit,hesaid.
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DENTISTRY
Adjunct Faculty Teach Students, Help Patients
Justin Dugas, DDS
I had some
amazing
instructors
when I was a
dental student,
especially Drs. Joe
Kolling and Dan
Edwards, said
Dr. Justin Dugas (DDS 2005).
They wanted me to succeed,
to understand what I was doing
and why. They took the time, even
ater hours, to explain procedures or
techniques when I had questions. Im
trying to emulate them, so thats why,
since January, I have been here one
day a week, he added.Dugas, who practices in Dearborn
our days a week, spends Tuesdays
in the Clinic helping patients, when
needed, but mostly supervising dental
students and guiding them.
But his counsel extends beyond
dental plans and treatment.
Because Im so close in age to the
ourth-year dental students, I oten
nd that Im a resource or career
advice, he said. Many students,he said, have questions about being
in a private practice or whether
they should enter an AEGD or GPR
program, so Im glad to answer those
questions too. I want to make the
same dierence in their lives that Drs.
Kolling and Edwards made in mine.
In addition to three staff dentists in the PAES Clinic, several private practice dentistsreturn to the Clinic one day a week to teach students and help patients.
John Seago, DDS
Its a great
honor to give
something
back to this
School and
this University
or the great
education I
received, said Dr. John Seago (DDS
1986).
Being here in the PAES Clinic
every Wednesday is my way o
showing my appreciation and,
I hope, will inspire some dental
students to think about also doing
this as their way o giving back in
the uture.Seago, who r uns a private
practice in St. Clair Shores our
days a week, has been an adjunct
instructor in the Clinic or nearly
two years. I keep returning because
it seems theres something new
everyday, he said. This is also
a great learning environment or
the students and I enjoy the many
opportunities I have during the day
to pass along some o what I havelearned to help them.
Aaron Ford, DDS
Unlike his two
other adjunct
colleagues, Drs.
Justin Dugas and
John Seago, Dr.
Aaron Ford is
the new kid on
the block. Ater
earning his dental degree in May, he
began working in the PAES Clinic a
month later.
It eels a bit strange seeing
and talking to some o my ormer
dental classmates, he said. But Im
excited to be here at the School and
helping patients.
Ford, who is in the Clinic onThursdays, spends his other our
days providing oral health care in
downtown Detroit as a part o Dr.
Amid Ismails oral health disparities
program.
Eventually, Ford said he would
like to work in a private practice
ater his wie completes her
emergency residency program at
Henry Ford Health System in Detroit.
From November 2000 to May2001, Ford was with the U.S. Army
as a medical platoon leader at Camp
Doha, Kuwait, where he oversaw the
treatment o over 900 patients and
20 MEDEVAC situations.
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FA C U LT Y P R O F I L E
Stephen Stefanac, DDS, MS
Associate Dean for Patient Services
Clinical Professor of Dentistry
e supervises one o the Schools largest departments
with more than 80 employees working in 11 dierent
areas. So theres plenty to keep Dr. Stephen Steanac
busy on any given day.
However, away rom the School o Dentistry, theres another
side not many see.
His hobbiesas a potter and restorer o old pinball
machinesare activities that help him to get away rom it all
when hes not at the School o Dentistry.Steanac returned to the U-M School o Dentistry in the
summer o 2004 as associate dean or patient services, a position
similar to the one he held or six years at the College o Dentistry
at the University o Iowa.
He earned a bachelors degree in biological sciences rom U-M
in 1976 and a masters degree in oral diagnosis and radiology 11
years later.
The Infuence o a U-M Dentist
Family and riends are here, and some o my ondest
memories are o my days here as a student, as well as when I
was living here in Ann Arbor and running my own practice in
South Lyon and practicing part time in Detroit. So it was natural
to want to return, he said.
What Steanac seems to especially cherish, now that hes
back in Ann Arbor and at the School o Dentistry in a leadership
role, are the opportunities to meet and talk to Dr. William Gregory
(DDS 1953, MS 1983), an adjunct clinical proessor.
Per Kjeldsen
H
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